I keep going back and forth on this topic, this forum has a lot of vibrant activity so I was hoping for some input and counterpoints if its worth committing to Tandem now or playing the wait and see game through 2020.
Current regimen: Medtronic 751 (530G) + Dexcom G6
A1C’s : 7.0-7.5 over the past 18 months
Pump is out of warranty
Would consider DIY LoopDocs, but I have some reservations relying on a system that introduces new potential points of failure: 1) Old pump (722 & 723), 2) Riley Link, 3) code, 4) phone. I am inspired by what the Looping community has done here, but my preference would be to wait things out for Tidepool to succeed with the FDA and be released with a compatible ACE designated pump that is in warranty.
Omnipod is not an option as I need a 300 unit reservoir.
I’ve done all my research on Basal IQ & Control IQ. I’ve thoroughly researched its limitations and abilities. I still have some open questions I’m awaiting Tandem to answer and clarify as to how Control IQ behaves once the pump has exceeded 100 units delivered in a day, and how aggressive its basal adjustments are when it predicts a high or low; one of their product support sales reps told me last week that the system may ramp up to as high as 15 units an hour (15u/h also happens to be the pump’s max basal rate) but I have my doubts if Control IQ would manipulate basals so aggressively if it wil only issue bolus corrections at 60% of sensitivity and correction factors
I have reservations on acquiring T:Slim X2 now so late since it’s hardware debut and being locked into the platform once others and Tandem introduce updates.
I like the Medtronic reservoirs, AAA Battery, being able to Bolus by touch from my pocket discreetly in public or easily while driving if necessary. The Tandem hardware although it is more iPhone than Beeper concerns me: The screen getting cracked, having to charge the battery, concerns over eventual battery degradation
I have zero interest in 670G with what I consider its half baked Auto Mode + inferior Guardian 3 CGM system. I wouldn’t mind a future Medtronic pump if it worked with G6 but there does not seem a timeline for when Medtronic will have an ACE approved pump to work with Tidepool & Dexcom. I know Medtronic will share 780G trial results at the ATTD Conference in Spain in late February 2020; however that appears to be a pump with more aggressive algorithms + bluetooth, but still use the Guardian 3 sensors.
I’m tempted to commit to Tandem as soon as tomorrow for the simple reason of tying my CGM to my pump so as to increase % time by getting more aggressive on my basals and in-turn protect me from night-time hypos. Again, the consideration is what do we know coming in the near term, and is it worth waiting out the market?
Tandem will be introducing their sport pump which will only hold about 200 units.
Other than that, I don’t really see any other ‘new’ pump from them in the pipeline.
But, the biggest thing is that the pump updates, and ‘most’ of the new fangled things coming out are just that, updates. So you can stay current if you wish.
The glass screen on the X2 is actually VERY strong! I work on vehicles somewhat often, leaning over radiators, beds, corners, etc.
I also do a lot of other heavy work where I often hit the pump.
I wear it in a spibelt at my waist, so it is always getting hit. But no issues yet.
The battery is easy to charge, even if you are lazy! I sporadically charge mine during the week (I used to be very conscious and charge it all the time.)
And, you can always start off with Basal-IQ for now and see the results from everyone else using Conrol-IQ.
Basal-IQ helped me drop my A1c from 5.8 down to 5.2.
Tidepool has no plans to release anything other than the OmniPod loop in 2020, this is contingent on them getting FDA approval.
Tandem will be launching the tubeless t:Sport at the end of this year. Tandem’s whole business model is software upgradeable pumps, don’t expect big changes in hardware or looks. I’d expect the X2 to be their flagship pump for the next 10 years at least.
Medtronic will most likely launch the 780 in the next 6 months.
This is everything slated for 2020, I’m excluding OmniPod as you’ve said they don’t fit your needs.
I was told this week by a Tandem local rep that there are no plans to make the syringe visible which is one of my concerns, as I am in late stage planning/thinking to pay out of pocket for X2 from a Medtronic 630 (2 more years b4 pump change due).
I need 300u syringe also and would not be interested in the pod option regardless. Their focus now seems to be on the “sport” option. Having a tube has never bothered me.
While I’m a big fan of Tandem, don’t discount Omnipod because of reservoir size. You can always get insulin in more concentrated u-200 or u-500 varieties.
You also shouldn’t let screen durability be a deciding factor. Medical devices are way different than consumer grade devices, which are usually intentionally engineered to fail after a certain time. It’s got a better screen than you will ever find in a cell phone. I’ve dropped mine several times a day for the last two years (it liked to pop out of my shirts when I bent over, before changing clips), and there’s not a single scratch on it… Let alone a cracked screen. They also come shipped with a screen saver pre-installed, if that’s any consolation. And Tandem is pretty awesome with the replacements, if anything does happen to it. Same day replacement if you live in a big urban area, they’ll overnight it to you if not.
The t:slim x2 also allows for quick boluses without looking. I have mine set to half unit increments, but you can change that and also opt to count carbs instead of units of insulin. You can also change the noises associated with it. Mine if set to only vibrate for discretion. I hold the power button until it vibrates (or beeps), press the button one time for every half unit I want to deliver and wait. It will repeat the same number of vibrations (or beeps) back to me for confirmation. Hold the button to confirm delivery or ignore it to cancel.
I think you should at least wait and put some thought into what’s most important to you.
If tubeless and fully customizable looping is most important, then think Omnipod with concentrated insulin. If sticking with familiar battery, reservoir, and controls is most important, then wait to see what’s happening with the next generation of Medtronic. I’ve not read much positive about the 670G, so it can only get better. Personally, I’d choose the Tandem again if I had to choose, because of the software updates, touchscreen interface, compact size, rechargeable battery, cgm integration and automated insulin adjustments… But those were more important to me than some of the things you specified.
If your pump is still functioning well and you like it, I don’t see any reason to force a decision.
If you’re seriously thinking Tandem, you’re going to have to adjust your way of thinking about b syringes and reservoirs. There is no syringe to make visible, other then the oversized 3ml syringe you use to fill the cartridge… The disposable cartridge is literally just a plastic bag inside an black plastic casing. You wouldn’t actually be able to discern anything if you could see inside. It would be like trying to gauge the volume of a vacuum sealed Ziploc bag stuffed inside a Tupperware container.
There is roughly ~30 units (they claim 20) of insulin lost to the reservoir as “dead space”. I actually suck that out with the syringe and add it to my next cartridge. Other than that, you’ve just got to trust the pump display.
Wow, pumps are such a personal thing. What I like, you might hate.
I have been pumping since 1990 and started with Minimed/Medtronic. In the 30 years I have been pumping I had 3 Minimed pumps and 2 Tandem.
I used those Minimed pumps forever. They were reliable and I never had any problems with them. So 3 pumps in 25 years means they make a very reliable product. My biggest problem was always the lack of progress. Which is why I used pumps way out of warranty. Why change if nothing is really new?
I made the switch to Tandem 5 years ago and should have waited because I got the old t:slim. But I must say, I did really like the changes that had been made over the years. I did get the Tandem X2 over a year ago and must say I love it so very, very much! I don’t test anymore using the Dexcom G6 and my urgent lows are completely gone. The loading process was a bigger deal but now after 5 years, I don’t even think about it.
And I am eagerly waiting my email to get the Control IQ. One of the endos I work with has been testing it and after looping for a few years, has made the switch to this system. It’s easy! That was the biggest thing for me! Easy! I am so into easy now.
But with all the pumps going into the market, if your current pump is working, take your time. Check all of them out. Many will be coming in the next year or two. I do recommend meeting with reps to see the pump and get the feel for all of them. So many options! It is a good thing to have choices unless you have one of those insurance companies that don’t give you options. Good luck with your choice and ask questions!
